Hiv antigen/antibody, combination assay, screening
Medicare pricing data for 614 providers across 39 states
This procedure has a 5.4x markup — hospitals charge $126.09 but Medicare allows only $23.55. Uninsured patients may face bills 5.4 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Hiv antigen/antibody, combination assay, screening (HCPCS code G0475) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $23.55, but hospitals typically charge $126.09 — a 5.4x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $23.55, your out-of-pocket cost would be approximately $4.71. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.4x more than what Medicare allows for this procedure. Medicare actually pays $23.55 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Georgia | $24 | $112 | 1 | 530 | +0.2% |
| Hawaii | $24 | $100 | 1 | 29 | +0.2% |
| Indiana | $24 | $85 | 8 | 95 | +0.2% |
| Iowa | $24 | $38 | 10 | 13 | +0.2% |
| Kansas | $24 | $122 | 3 | 899 | +0.2% |
| Kentucky | $24 | $63 | 3 | 27 | +0.2% |
| Louisiana | $24 | $120 | 10 | 27 | +0.2% |
| Maryland | $24 | $101 | 4 | 129 | +0.2% |
| Massachusetts | $24 | $99 | 4 | 1,087 | +0.2% |
| Michigan | $24 | $84 | 3 | 49 | +0.2% |
| Missouri | $24 | $48 | 8 | 14 | +0.2% |
| Montana | $24 | $61 | 1 | 14 | +0.2% |
| Nevada | $24 | $112 | 1 | 42 | +0.2% |
| New Mexico | $24 | $66 | 1 | 205 | +0.2% |
| North Dakota | $24 | $111 | 10 | 179 | +0.2% |
| Ohio | $24 | $142 | 6 | 1,569 | +0.2% |
| Oklahoma | $24 | $60 | 1 | 153 | +0.2% |
| Oregon | $24 | $80 | 5 | 249 | +0.2% |
| Pennsylvania | $24 | $109 | 5 | 357 | +0.2% |
| South Dakota | $24 | $84 | 5 | 100 | +0.2% |
| Tennessee | $24 | $162 | 6 | 87 | +0.2% |
| Virginia | $24 | $85 | 2 | 421 | +0.2% |
| West Virginia | $24 | $164 | 2 | 19 | +0.2% |
| Colorado | $24 | $153 | 2 | 122 | +0.2% |
| California | $24 | $127 | 18 | 3,313 | +0.2% |
| New Jersey | $24 | $154 | 2 | 1,187 | +0.1% |
| Illinois | $24 | $111 | 3 | 547 | +0.1% |
| Alabama | $24 | $158 | 2 | 885 | +0.0% |
| Arizona | $24 | $125 | 12 | 517 | 0.0% |
| Florida | $24 | $142 | 4 | 1,170 | -0.1% |
| North Carolina | $24 | $178 | 52 | 2,842 | -0.1% |
| Texas | $24 | $125 | 61 | 2,339 | -0.1% |
| Washington | $24 | $83 | 66 | 2,290 | -0.2% |
| Minnesota | $23 | $92 | 221 | 1,107 | -0.5% |
| Wisconsin | $23 | $102 | 7 | 119 | -0.6% |
| South Carolina | $23 | $117 | 3 | 172 | -0.9% |
| Maine | $23 | $75 | 36 | 57 | -1.5% |
| Nebraska | $23 | $54 | 15 | 55 | -1.6% |
| New York | $23 | $291 | 4 | 108 | -3.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber